Monthly Archives: October 2014

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Representatives of seven of the most popular gay dating websites and apps have collaborated with leading US AIDS organizations to discuss strategies to help promote HIV/STI testing and to reduce the stigma associated with HIV infection. The results of a San Francisco summit between representatives of the dating sites and health leaders – including San Francisco AIDS Foundation, and amfAR, The Foundation for AIDS Research – have been published in a new report.

Across the US, around 20% of gay and bisexual men are estimated to be living with HIV, while some estimates indicate that 3 in 5 men now meet their partners online. The apps and websites that were able to attend the summit – which took place over two days in early September – included BarebackRT, Daddyhunt, Dudesnude, Gay.com, Grindr, PozPersonals, and SCRUFF. Three other apps were unable to attend the summit but have pledged their support.

Some doctors have been reluctant to prescribe the drug, Truvada, on the premise that it might encourage high-risk, unprotected sexual behavior. However, its preventive use has been endorsed by the Centers for Disease Control and Prevention, the World Health Organization, and many HIV/AIDS advocacy groups

The Human Rights Campaign, which recently has been focusing its gay-rights advocacy on same-sex marriage and anti-discrimination issues, joined those ranks with the release of a policy paper strongly supporting the preventive use of Truvada. It depicted the drug as “a critically important tool” in combatting HIV, the virus that causes AIDS. “HRC does not take this position lightly,” the policy paper said. “We recognize there is still ongoing debate … and that there are those out there who will disagree with our stance.”

Truvada has been around for a decade, serving as one of the key drugs used in combination with others as the basic treatment for people with HIV. In 2012, the Food and Drug Administration approved it for pre-exposure prophylaxis, or PrEP — in other words, for use to prevent people from getting sexually transmitted HIV in the first place. “Today, there is an unprecedented chance to end the HIV/AIDS epidemic, in part through PrEP’s aggressive prevention of new HIV infections,” said Chad Griffin, president of the Human Rights Campaign. “There is no reason — medical or otherwise — to discourage individuals from taking control of their sexual health and talking to their doctor about PrEP.”

The CDC says studies have shown that Truvada, when taken diligently, can reduce the risk of getting HIV by 90 percent or more. Research discussed at the International AIDS Conference in July found that use of the drug does not encourage risky sex and is effective even if people skip some doses.

As part of its announcement, the Human Rights Campaign called on insurers, regulators and Truvada’s manufacturer to take steps to reduce costs, raise public awareness, and make the option available to all medically qualified individuals who could benefit from it, regardless of ability to pay.

The cost of Truvada varies widely; a New York State Health Department fact sheet gives a range of $8,000 to $14,000 per year. The manufacturer, California-based Gilead Sciences Inc., has a program that provides assistance to some people who are eligible to use Truvada but cannot afford it.

The Human Rights Campaign urged all states to emulate Washington state, which implemented a program earlier this year offering assistance in paying for PrEP. The preventive option also was endorsed by New York Gov. Andrew Cuomo when he announced initiatives in June aimed at ending the state’s AIDS epidemic by 2020.

The HRC called on state insurance regulators to take action against any insurers who deny legitimate claims from patients who’ve been prescribed PrEP by their doctors.

A prominent provider of services to HIV-positive people, the Los Angeles-based AIDS Healthcare Foundation, remains a vocal critic of the preventive use of Truvada. In an ad campaign launched in August, the foundation says many gay men fail to adhere to Truvada’s once-a-day regimen and describes government promotion of the drug as “a public health disaster in the making.”

Even though Hispanics in the United States become infected with HIV at rates triple those of whites, less than half of Hispanics with the virus are receiving adequate treatment, a new report finds. The report, based on 2010 U.S. government health data, finds that while 80 percent of HIV-infected Hispanics do receive care soon after their diagnosis, only about 54 percent continue that care and only about 44 percent receive the virus-suppressing drugs they need to stay healthy.

The researchers, led by epidemiologist Zanetta Gant of the U.S. Centers for Disease Control and Prevention (CDC), also found that only 37 percent of the more than 172,000 HIV-positive Hispanic adults in the United States have the virus under control. HIV is the virus that causes AIDS. The findings “underscore the need for enhanced linkage to care, retention in care, and viral suppression for Hispanics or Latinos,” Gant’s team writes in the Oct. 10 issue of the CDC journal Morbidity and Mortality Weekly Report.

The medical school at the University of California, San Francisco, has opened a free telephone consulting service for doctors who are not H.I.V. specialists and want help prescribing the right AIDS drugs for preventing infection in healthy patients.The service, known as PrEPline for pre-exposure prophylaxis line, was announced last week.

In pre-exposure prophylaxis, patients at high risk for H.I.V., such as gay men who frequently have unprotected sex with strangers, ward off infection by taking Truvada, a pill containing two antiretroviral drugs. Uninfected men, if they have doctors at all, usually see general practitioners, who rarely prescribe antiretrovirals. By contrast, doctors at U.C.S.F. have decades of experience in treating H.I.V. because San Francisco was an early center of the outbreak.

The new hotline is aimed at American doctors, but if PrEP is rolled out around the world, it could be a model for other countries, said Dr. Ronald H. Goldschmidt, the director of the school’s clinical consultation center. Since 1993, he said, the center has fielded phone calls from doctors seeking help. Typically, they are obstetricians treating pregnant women infected with H.I.V.; emergency-room doctors treating nurses who have had a needle injury; or patients who had sex with someone they suspect is infected.

South Africa and Ethiopia have sent doctors for training to offer similar services at home, he said; prophylaxis is still rare in poor countries because they are struggling to pay for medicine even for those with advanced AIDS.

Despite recommendation by the Centers for Disease Control and Prevention, and studies that indicate that PrEP can reduce HIV transmission by 96 and up to 99 percent, there are still relatively few gay and bisexual men on the drug.

It can be hard to find anyone among your friends to ask about it. And what makes a person decide they want to go on the once-daily pill varies a lot.The Advocatereached out to gay and bi men, as well as serodiscordant couples, who use the drug to hear their reasons. They offered advice for those on the fence about it. Read their stories in their own words.

People living with HIV in the United States who receive their care through the Ryan White HIV/AIDS Program have good rates of retention and virological suppression, investigators report in the online edition of Clinical Infectious Diseases. Of the patients seen at least once in 2011, some 82% were retained in care and 73% achieved virological suppression.

These outcomes dwarf those seen for most people living with HIV in the US –previous reports have estimated thatas few as 40% were retained in care and 19% had achieved virological suppression.

A second new report focuses on gay, bisexual and other men who have sex with men, demonstrating that outcomes continue to be unacceptably poor in this group. Of those who have ever been diagnosed with HIV, 51% were retained in care and 42% achieved virological suppression.

However, both new studies found that outcomes were poorer in younger people, African American people and some other ethnic groups.